The use of accommodating resistance was made popular by Louie Simmons of Westside Barbell. Now a days accommodating resistance is not only used by powerlifters, but by high school and college strength and conditioning programs, as well as the general public. When I was an intern at Harvard University, many of the coaches used bands and chains in their programs.

You definitely do not need to use bands and chains to get stronger. Plenty of people have put up huge totals without the use of accommodating resistance. However, a recent meta-analysis shows that the use of bands and chains can lead to faster gains in strength when compared to conventional training (1).

I don’t know about you, but if there is the chance I can put up bigger numbers faster, I am going to incorporate it into my training. Accommodating resistance goes beyond building strength as well. They even serve a purpose with novice lifters.

Having chains hanging from a bar will teach that novice lifter to stay tight because the chains are constantly swinging back and forth. With that said, we want to make sure we have a link or two on the ground at lockout so that we do not have too much swinging happening. Bands and chains also teach novice lifters how to accelerate throughout the range of motion.

Also, it can help maximize technique because the weight deloads in places we tend to see technique breakdown. For example, many beginners will have the hips pop up out of the hole turning the squat into a good morning. Deloading some weight at the bottom can help them keep their chest up while getting some higher intensity work.

So why would using accommodating resistance make you stronger in the big three lifts? For one, we can quarter squat much more weight than we can take below parallel and come back up with. This is due to the various joint angles of each of the movements. Accommodating resistance can match the strength curves of each of these lifts.

The chains or bands deload at the bottom and increase in weight or tension as the lift approaches lockout. This matches the strength curve of the lift, as it is most difficult at the bottom portion and easiest as we get closer to lockout.

With that said, we all have weak spots within that ROM. We call these our sticking points. As a raw lifter, the sticking points will be the same for everyone, as there are more disadvantageous joint angles in each lift. For the squat below parallel is not the problem, but actually a couple of inches above parallel is where the bar will slow down. So don’t cut your squats high! The bench press tends to be a couple of inches off of the chest, and the deadlift has a sticking point right below the knee.

Will some people struggle with locking out the bench press at the top, or the deadlift at the top? Absolutely, but this is an individual weakness. For the bench you need to add in more triceps work, and the glute work for the deadlift. Oftentimes lifters missing at the top of the pull miss the lift because of technical breakdown. They do not use enough legs and the back cannot handle the weight to lock it out.

If everyone has these same sticking points how do we strengthen them to keep our numbers moving in the right direction? We learn to accelerate the bar faster. The more speed the bar reaches those sticking points with, the better chance we have of it moving beyond that sticking point.

Even if you have those personal weaknesses we discussed earlier, bands and chains can help you overcome them. You need to keep accelerating the weight throughout the ROM. If you miss at the top, the bands and chains are constantly adding more tension and weight throughout the movement and forcing you to accelerate the bar through that weakness.

Not only do bands and chains teach us to accelerate the weight, they also teach us how to decelerate the weight. This may be where accommodating resistance has its biggest positive effects on field athletes, as change of direction requires us to decelerate our bodyweight and accelerate in another direction.

More advanced lifters have a slower, more controlled eccentric portion of the lift and a faster concentric portion of the lift when compared to novice lifters (2). Bands and chains are forcing you to learn how to do this. You need to stabilize against the bands and chains when the weight is heaviest at the top. This leads to a slower and more controlled eccentric portion, and due to the deload at the bottom, it teaches you to move the weight faster throughout the concentric.

Now that we know that bands and chains are an important tool to add into our training, here is how I use them. I am a raw powerlifter and I train raw powerlifters. How single ply and multi-ply lifters use bands and chains will differ quite a bit. Geared lifters need to focus on overloading the top portion of the lift a lot more than raw lifters.

A geared lifer may have a 600lb raw squat, but can squat over 800lbs in briefs and a suit. The gear will help pop them out of the bottom of the squat, so they need to be really strong at the top and really good at accelerating the weight throughout the ROM. Technique is critically important here as well. Less bar weight and more accommodating resistance makes sense for them.

As a raw lifter you need to be strong enough to accelerate the weight out of the bottom, but will never have to overload the top of the lift like a geared lifter. We need just enough accommodating resistance to achieve that acceleration, but not so much that it changes the movement and decreases intensity too much at the difficult portions of the lift.

If I squat 600lbs and use 200lbs of straight weight with 400lbs of band tension, the overload at the bottom of the squat is not enough to strengthen that position. It would only be 33% of 1RM. If I am weak at the bottom as a raw lifter, it does not matter how much I can lockout at the top, because I will never even get past that first sticking point.

Looking at the force velocity curve you can see what I am talking about. Maximal strength is at the left end and speed is all the way down to the right. Force makes up the vertical axis and velocity makes up the horizontal axis. As force decreases, velocity increases and vice versa. If we only strength train (blue line) our speed will go down and if we just focus on speed (green line) our maximal strength will decrease. We want to train in a way that allows us to shift this chart to the right.

We want to work with weights that provide adequate velocity and force. Weights that are too light will move fast, but hinder our maximal strength. Weights that are too heavy will move too slowly for us to be able to accelerate that weight through our sticking points. According to this curve we want to stick to weights that are no lighter than 65% and no heavier than 82% of 1RM. This is where the ideal spot is on that curve to develop the biggest total.

We want to develop maximal intent to move the weight fast and not just move the weight fast. If our aim is just bar speed, we run the risk of using intensities that are too low to get stronger. Remember that the overload principle applies here. Speed days for Westside are lighter and allow the lifters to recover from the very intense max effort days that they have, because if they are in their gear, they are lifting more than they are capable raw. This wrecks the nervous system, and light days are critical.

How I utilize chains is that I mimic how Sheiko has used them with me. Mimic those that have done it best, understand why they do it that way, and then make the changes necessary to maximize it. I will program accommodating resistance with straight weight between 65% and 75% of 1RM. The accommodating resistance never exceeds roughly 20% of the total weight on the bar.

When using chains, use one 15lb to 20lb chain per side. The chain should fully deload at the bottom, and finish at the top with one to two links on the floor. I use bands and chains for both deadlifts and bench press, but only chains for squats. Squats with bands can be a little rough on the hips. With all of the volume that I am programmed, and that I program, it is best not to risk it. Chains work just fine for the squats. When using bands, EliteFTS has a chart of approximate resistance for the bands. Make sure that the weight is 20% or less of the total weight on the bar.

Load variation is also important if we want to progress as much as possible as fast as possible. Accommodating resistance allows us to vary the load. It also allows enough of a variation to technique to keep adaptive resistance at bay. In a prep cycle I like to utilize 20% competition lifts and 60% variation. This changes closer to a meet. Within that 60% I will use pauses and accommodating resistance. The goal is to strengthen those sticking points and learn to accelerate through them. You can get stronger without the use of accommodating resistance, but science has shown you can get stronger, faster with it.

It’s been a long time in the making (or has felt like it to me anyway) but we are getting closer to the release of my second book, Wired to Eat! The official release date is March 21, 2017 but since we are close to finalizing the cover and a few other details I thought I’d do a quick post to let you know where this project is.

What is Wired to Eat?

In the past ten plus years of working with people and helping them to change their eating and lifestyle I have fortunately seen and played a part in a lot of incredibly positive and inspiring change. If you check out some of the testimonials we’ve received or spent a bit of time on social media you have likely seen some incredible transformations. But not everyone gets the “brochure” experience when changing diet and lifestyle. For some folks they either can’t get going on these changes or (more often) they make some solid progress, only to spin out a few months down the road. I’ve talked to a lot of people, done a lot of thinking as to why this happens and what I’ve noticed is a destructive ”self talk” that consistently derails folks. When people get into the thick of change they are struck by the difficulty of the whole process. They think there is something wrong with them, that they have some kind of moral or constitutional failing. If they could “only be better, stronger, have more willpower, etc.” everything would be “ok.” This thinking misses some key points that are literally cooked into our genetics. If you find navigating the modern world of hyperpalatable foods tough, you should NOT be surprised. We are genetically wired to eat more and move less; it’s no wonder most people fail to achieve health and weight-loss goals.

Wired to Eat is my attempt to explain this story in a way that defuses the guilt and morality around changing our eating and lifestyle habits. I talk about the neuroregulation of appetite and how hyperpalatable foods cause us to eat more than we otherwise would. I cover some of the latest research surrounding the gut microbiome, ketogenic diets/fasting, and how depending on certain life events some of us are better suited to higher or lower carb diets.

This is a pretty big (long!) book and I bring in sleep/photoperiod, movement (exercise), and community in addition to nutrition to establish what I call the Four Pillars of Health. I look not only at how these topics affect the neuroregulation of appetite, but also our overall, happiness and wellbeing.

There is a lot of “why” in this book, the science geeks will not be disappointed. Building on the “why” is a step by step program to help readers easily rewire their appetite, control blood sugar, and determine the foods that work for them (turns out we’re unique snowflakes after all). As to recipes and chow, Charles and Julie Mayfield of Paleo Comfort Foods put together amazing meal plans ranging from autoimmune to ketogenic and everything in between.

Where can you get it?

Wired to Eat is available for pre-order everywhere books are sold. If you are feeling frisky and want to pre-order, I’m including a few handy links to do so below. If you want to support your local bookseller, you can also order early from them.

As we get closer to release I’ll update you on more details of the book, the release schedule and some special offers we will have in the all important pre-release campaign. Thanks again for the continued support!

This episode we have guest Dr. Marianne Brandon. Dr. Brandon is a clinical psychologist and Diplomate in sex therapy. Dr. Brandon served as a board member for an International Sexual Health Society, and also co-hosted an exciting sex therapy radio show called “In Bed with Dr. B and Ted”. She is the author of multiple books, and has a practice in Annapolis, MD. Listen in as we talk all about sexuality, monogamy, evolution, and more.

30 Day Guide to the Paleo Diet

Want some extra help? Have you been trying Paleo for a while but have questions or aren’t sure what the right exercise program is for you? Or maybe you just want a 30-day meal plan and shopping list to make things easier? We’ve created a getting started guide to help you through your first 30 days.

I spent five-and-a-half years at university. Throughout that time I performed well but always wished there was some way to improve my memory, thinking and imagination. As with most campuses, an underground market of Adderall and Modafinil existed, but given the possibility of strong side effects I never indulged. During the final 3 weeks leading up to my thesis defense I lived on green tea, black coffee and as little sleep as I could tolerate.

Less than a month after graduation, I mentioned how tough it had been to a friend and how glad I was it was over. Someone asked me if I had tried noots. I didn’t know what I was being asked. He explained that nootropics are non-pharmaceutical grade cognitive enhancers. I wondered why I never heard anyone mention these in the last 5 years.

That night, I Googled nootropics and fell into a rabbit hole of racetams, exotic chemicals, PubMed, Examine, research articles, herbs and adaptogens. I realized immediately that this was something I had to figure out.

I ordered a scale and began weighing and measuring different chemicals and ingesting them. This was done haphazardly and the effects were all over the map. When I began stacking (mixing) different nootropics to enhance the overall effect, I began to mix placebo pills into my batches and I’d measure focus and memory using basic internet games and around when I needed a coffee at work. Not the most scientific study but miles ahead of most people who ingest recreational chemicals.

Over time, people began asking me for samples during projects or for big negotiations. I’d make them a week’s supply. Then they’d come back and ask for more, and I realized I had hit upon a winning combination.

It took years of trial and error, research and testing formulas against placebo pills. When 87% of the first trial team decided they would buy a second batch and began handing cash over- the business was born.

Now, we are playing with the brain here so let’s use common sense. Use the supplement as directed, 2-4 pills/day for 5 days/week for up to 3 months. Take 1 month off to let your body reset. Habituation leads to a poor effect. Make sure you’re over 18 and preferably over 21, as we don’t know if this influences how brains grow- and that basically goes for every supplement on the market except fish oil. Make sure you’re in reasonably good physical and mental health and you aren’t pregnant.

Philosophically speaking, you can crank the brain (or the heart, the muscles or most bodily systems) to 11/10 for a few hours and nothing bad happens if you are healthy. On the other hand if you crank the system to 17/10, there will be consequences. This is one of the reasons why avoiding habituation and cycling your nootropics every few months is important.

So, what’s in them? My first stop was the natural aisle. Taking natural substances that can get past the blood brain-barrier felt safer because dosage guidelines are established. After all, if we’ve been taking an herb, root or mushroom for over 4000 years, we know the danger is minimized. A research chemical developed 25 years ago may or may not have long-term consequences to your brain.

Ginkgo biloba is a Chinese herb which improves memory, cerebral blood flow, dopamine and serotonin sensitivity, and slows cognitive decline. Even small doses have measurable effects. Lion’s mane mushroom is in almost everything I take now. When I first came across the data I was floored I hadn’t heard of this before. Yamabushitake stops cognitive decline, prevents plaques from building, improves memory, reduces depression and anxiety, helps build new neurons and myelin and improves blood values. Doses are relatively high, generally over 1g, to get measurable effects but they are well worth it. This is the backbone of most stacks I make now. Alpha-GPC is a choline provider. In all the mitochondria throughout your body, acetylcholine is needed to move or to provide energy. For a more detailed explanation, watch this video:

A textbook 150lb human needs 3.2-6.6g of choline/day, depending on how much physical and mental activity they are performing. Whenever you are going to overclock the brain, giving it some extra raw material to burn through makes sense. Lastly, a racetam. The racetam family has been at the heart of the nootropics revolution since the beginning in the 1950s, when Soviet scientists wanted to develop a sleep drug and instead made a molecule that improved memory. For the flagship product, coluracetam was added, the most powerful racetam that is currently legal under WADA. Some racetams have been banned by this organization and wouldn’t it be terrible to win an event and be stripped of a medal because of the cognitive enhancer you took for your creative side project?

Beyond memory, cognition, mood and creativity, some friends approached me and asked for something their parents could take to prevent Alzheimer’s dementia. This was a tall order but I dove into PubMed to see what could be done. This research led to an all-natural product designed to maximize the brain’s longevity. The brain ages through systemic inflammation and a build-up of proteins that cannot be flushed out. Reducing inflammation and getting these proteins out increases cognitive longevity.

I started with lion’s mane mushroom, given its known effects of preventing plaque build-up and helping to construct new brain cells. I added curcumin to reduce inflammation. Curcumin is hard to absorb on its own, but in the presence of black pepper the body takes it in. The herbs rhodiola rosea and ashwagandha were both added in sufficient doses to have effects. Ashwagandha reduces stress and improves mood while balancing brain chemistry and rhodiola reduces fatigue and depression while improving physical and mental endurance. Keep in mind, the goal of this stack is to keep one sharp for as many years as possible. All nootropics should be taken with a fatty source since fat easily passes the blood-brain barrier. I recommend eating fish with your nootropics in the morning. If you do bulletproof coffee, take it with MCT oil. If you are doing intermittent fasting and not eating until the evening, you can take the nootropics in the morning. They will not absorb as well but some will still pass. The other option would be to take them with a fish-oil or krill-oil capsule, just to get some fat to maximize absorption.

If you have any questions about nootropics or my stacks, please contact me at Guy@mxel.com

Also, if you decide to try any of the products, the code robb5 at checkout will get you 5% off.

Guy Razi is a Physical Therapist and Kinesiologist who has turned his efforts to optimizing human performance in mental and physical domains. Having competed in elite fencing, wrestling and powerlifting he is well aware of the demands on athletes. As time went on, he started his business to rehabilitate clients and later to enhance and optimize with supplements.

Most medical doctors know very little about evolution, which is not surprising, given that the vast majority of medical students don’t learn much about evolutionary biology, Darwin’s theories, or ancestral health. The same can be said for practitioners and students who are involved in other health-related fields, such as nutrition. I should know, as I’ve studied both nutrition and sports science. During those years at school, I only heard the word evolution mentioned a couple of times, and never in the context of the etiology, pathogenesis, or prevention of human disease.I find this lack of focus on evolutionary concepts extremely concerning.

“Nothing” in nutrition or medicine makes sense except in the light of evolution. If doctors and nutritionists have no evolutionary framework to guide their understanding of health and disease, they are incapable of doing their jobs properly.

I strongly believe that an infusion of evolutionary science into health-related fields such as nutrition and medicine could revolutionize our entire medical system. To someone who is not knowledgeable about evolutionary biology or Darwinian medicine, this notion may seem far-fetched; however, to someone who’s dug into the scientific literature on the aforementioned topics, it probably doesn’t.

Humans, like all other organisms on this planet, are a product of evolution. There is a reason why our bodies work the way they do; a reason why we do better on some diets than others; and a reason why we get sick. To find these reasons, we need to look back and examine the evolutionary processes that got us to where we are today.

There’s an evolutionary explanation for “everything”. Sometimes, this explanation presents itself quickly and clearly, whereas other times, we have to dig long and hard before we find the answers we’re looking for. In the end, though, the explanation can usually be found via the evolutionary route. It may not be fully formed and explain everything we need to know, but it gives us a foundation upon which we can build our ideas and understanding.

I know this may seem abstract to a lot of people, so, in order to make things more graspable, I thought I’d illustrate the point with a few examples. Below are some medical-related questions that can be answered using evolutionary theory:

Why does antibiotic resistance develop?

What types of diets are humans best adapted to eat?

Why does our body temperature typically rise when we get an infection?

Why are humans so susceptible to develop back and knee pain?

How and why do some gut organisms “hijack” our brain?

Why are many diseases and health problems more prevalent today than they were in the Paleolithic?

What type of microbiota is the human body adapted to harbor?

Why do we think and act the way we do?

Why isn’t the human body “perfectly” designed?

Why and how do cancer cells evolve and spread?

Medical students learn a lot about the molecular mechanisms underlying disease; however, they learn little about evolutionary biology and ancestral health; hence, they are incapable of fully answering the questions above – which can only be properly answered using evolutionary logic.

The science of Darwinian medicine: 10 things we’ve learned over the past decades

In this article, I’m not going to take an in-depth look at the science of Darwinian medicine. That would require hundreds, if not thousands of pages. Rather, I thought I’d summarize some of the things we’ve learned over the past decades. Some of these things have been known for quite some time, at least within certain scientific circles; however, it’s only recently that they’ve received solid scientific support.

Many human diseases and health problems, including acne vulgaris, type-1 diabetes, heart disease, obesity, and the metabolic syndrome, are caused, in large part, by evolutionary mismatches (i.e., a mismatch between the human genome, which is comprised of genes selected in the past, and the modern milieu, which differs markedly from past environments) (1, 2, 3, 4, 5).

Cancer evolves via natural selection (6). In order to understand how cancer cells develop and spread, we must first understand the game of evolution.

Humans’ microbial environment has changed dramatically over the past 10.000 years (7, 8). These changes have likely contributed to driving the increased incidence and prevalence of many chronic diseases, in particular those that are associated with chronic inflammation (7, 8).

Modern, imprudent diets change the gut environment in such a way that a microbiota that is incompatible with human genetics develops (9, 10, 11). These changes occur as a result of selective processes in the gut; when the environment changes, the microbiota also changes; those microbes that are best adapted to survive and reproduce under the new conditions proliferate, whereas those that are poorly adapted wither or die.

Paleolithic, hunter-gatherer style diets are useful in the treatment of many health problems and markedly improve body composition and markers of cardiovascular and metabolic health, among other things (12, 13, 14, 15).

Humans’ physical activity requirements were determined in the past. Many human diseases and health conditions, in particular those associated with the bones, cardiovascular system, and/or muskuloskeletal system, such as osteoporosis and heart disease, are partly caused by the replacement of a physically active hunter-gatherer lifestyle with a sedentary, modern lifestyle (16, 17).

Humans’ propensity to develop certain health problems such as back pain may partly be explained by the occurrence of trade-off situations earlier in human evolution. (E.g., when our ancestors started to walk upright, they became better at some things, such as looking over tall grasses, but worse at other things, such as climbing. They may also have become more prone to develop certain muskuloskeletal problems).

Humans didn’t evolve as single entities; we evolved alongside a cloud of microbes. A growing body of evidence shows that a progressive loss of biodiversity (biome depletion) from the human superorganism, starting about 10.000 years ago, with the transition from hunting and gathering to agriculture, may be at the root of a long list of health problems (7, 8, 18). Biome reconstitution, guided by evolutionary thinking, is a key measure required to slow down and reverse the increasing incidence of immune-related health problems in the developed world (7, 8, 18, 19).

I could go on; I haven’t even gotten into infectious diseases, which can also be “explained” by evolutionary theories. However, in order to keep this article from getting too long, I think we’ll stop there.

My impression is that the vast majority of scientists agree that evolutionary theory contributes to our understanding of health and disease. However, some make the case that it doesn’t help us much in terms of the prevention and treatment of disease. I disagree. After having read the list above, I think you probably do as well. As clearly shown in the summary, evolutionary science doesn’t just help us understand why we get sick, but it also informs us about what we should do to prevent and reverse disease.

That said, it’s important to remember that natural selection doesn’t select for health; it selects for reproductive success. It only “cares” about health if there is a link between the health of the organism and its ability to survive and reproduce. Usually, though, there is a link between the two. Even more so in the past than now, it was a tight connection between the physical fitness and evolutionary fitness of each member of our species.

Evolutionary science doesn’t necessarily provide us with clear-cut answers as to what we should do to combat disease; however, it does equip us with a conceptual framework that helps guide our understanding of health and medicine.

A gaping hole that needs to be filled

If the things I learned in school were all I knew about nutrition and health, I wouldn’t be very knowledgeable, and I certainly wouldn’t be able to give you a good answer to the questions posed earlier. In school, I learned a lot about chemistry, anatomy, physiology, and the molecular basis of disease, but I learned nothing about evolution, ancestral health, or Darwin’s theories.

If I was put in charge of designing the curricula of study programs in Nutrition and Medicine, I would definitely make some changes from their current state. Most importantly, I would add at least one mandatory course about evolutionary biology and ancestral health. Preferably, the students would have this course early on in their education, so that they are equipped with an evolutionary framework that they can use to understand and make sense of other subjects they learn about later in their educational journey.

I don’t claim to have all the answers, but if there’s one thing I know, it’s that modern medicine and nutrition are in desperate need of an infusion of evolutionary theory. Evolution via natural selection is the guiding principle in biology. Medicine and nutrition could be considered sub-disciplines of biology; hence, it goes without saying that Darwin’s theories are important also here.

Here’s what a 2016 research paper entitled Evolutionary Science as a Method to Facilitate Higher Level Thinking and Reasoning in Medical Training had to say about the importance of incorporating evolutionary science into medical education:

“Clearly, the ramifications of natural selection for medical practice and research are wide-ranging. To be prepared to practice medicine in the 21st century, medical students need to master the concept of natural selection, as well as other evolutionary concepts fundamental to medicine.

…we would argue that the relevance of many of evolutionary medicine’s tenets such as “evolutionary mismatch” is actually increasing. This is due to increasing globalization and the export of the Western lifestyle around the world, and the rate at which Western societies are accelerating away from the conditions under which our species evolved. These forms of environmental change will bring about new health challenges that will be best addressed with an evolutionary perspective.” (20)

Is change coming?

These days, new studies and papers about Paleolithic diets, the old friends theory, biome reconstitution, and other topics related to Darwinian medicine are published all the time. Unfortunately, though, this science has not made its way into universities and colleges. These institutions are slow to change; sometimes, it can seem like they reject change – even when new evidence is standing on their doorstep, knocking to get in.

Hopefully, as more and more research is published and the knocking gets louder and louder, they will open their doors. The question is: How long will it take before this happens?

I certainly hope it happens in the very near future, but I’m not convinced that it will. It takes time for paradigm changes to occur, in large part because the “establishment” – who’ve been practicing and teaching according to the same set of principles for decades – may be resistant to change how they do things. Their current understanding of health and medicine is so ingrained into their minds that they may dismiss “everything” that doesn’t fit into their established models.

That said, I think a change is bound to happen sooner or later. In nutrition, a field I’m very familiar with, signs of change are already clearly visible, in large part because a lot of Randomized Controlled Trials (RCTs) on Paleolithic nutrition has been published lately. To some people, in particular those who don’t know much about evolutionary biology and don’t understand what the whole ancestral health thing is all about, “hard science” is all that matters: Nothing less than a pile of RCTs and comprehensive meta-analyses will change their mind.

They don’t understand and are not convinced by explanations about gene-environment discordance, trade-offs, or other evolutionary theories; they need to see statistical results and p-values derived from randomized clinical trials before they even consider changing their opinions. Even then, they may be resistant to change how they think, typically because they don’t want to believe that they have been wrong or that another, perhaps seemingly more uncomfortable, path is better than the one they are currently on.

Last words

I’m looking forward to seeing how we approach health, nutrition, and medicine in the future. Hopefully, the approach we use in the future will be better – and more evolutionary sound – than the one we use today. A new paradigm may be developed by combining the best from both conventional and Darwinian/evolutionary medicine.

I couldn’t agree more with the researchers of the paper mentioned earlier, which had the following to say in their concluding paragraph:

“We argue that the future of medical research and practice will increasingly require an evolutionary perspective to address the new health concerns of the 21st century. These will include chronic disease, mental health, as well as other issues such as emerging pathogens. The ability of physicians and biomedical researchers to link ultimate evolutionary explanations for disease to their proximate mechanisms shall become increasingly important. Therefore the sooner we revise medical preparation to integrate evolutionary perspectives, the better primed we will be to address the medical challenges of the 21st century.” (20)

Eirik Garnas is a nutritionist, magazine writer, blogger, and personal trainer. He’s written for several different health & fitness websites and magazines, including Paleo Magazine. He is also the founder and owner of www.Darwinian-Medicine.com, a website dedicated to ancestral health, nutrition, and evolutionary medicine. Over the years he’s helped clients of all different ages, body types, and fitness levels build a healthier, stronger body.

In conversation with Murph the other day, he had asked what the point of performing a competition lift or its variation twice in one day serves. Upon answering the question, I realized there was a lot to it and many people must have the same question with the popularity of Sheiko programs in powerlifting. Performing a competition lift twice in one day is a big component of a Sheiko program.

Now, this article is 100% my interpretation of over one year of programming from Boris Sheiko. His reasoning for programming in this manner may or may not be different from my interpretation. I have had very good success with my clients utilizing this setup. Clients that range from those that just want to get into better shape as well as competitive strength athletes.

There is not much information out there that explains why Boris does his programming this way. However, he does state that it improves the technique of the competition lifts and it leads to greater strength progress. We will look at the first part of that statement first.

Technique is a priority for Boris. Every rep should look the same from 50% of 1RM up to a max single. The more reps that are in a set, the more difficult it is to maintain proper technique. Doing more sets and less reps is a way to get the same volume of training in, but with greater technique.

As we begin to perform many sets, we also begin to accumulate fatigue. Taking a break from the competition lift, performing a separate competition lift, and then coming back to the original lift allows us to recover enough to finish the volume with perfect technique.

For example, we may squat for 4 sets of 4 to begin the training session, bench press after, and then return to squats for another 4×4. This set and rep scheme works better for maintaining technique then perhaps performing 4 sets of 8. The total volume of the day will be the same, but in the 4×8 scheme there may be reps performed with less than ideal technique due to fatigue.

Splitting up the volume also allows us to work at a higher intensity for the volume. Breaking the sets down in half allows myself and my clients to work at 5%-10% more of 1RM while maintaining perfect form. When getting stronger is a goal, this is a win every time.

Also, powerlifting is a sport. We need to work on our sport to get better at it. This is the same as any sport. We need to analyze our lifts and strengthen our weak positions within those lifts. If I program a 4×8, all of the volume is done with just the lift itself, or only one variation. I am limited in what we can work on here.

However, splitting up the volume allows me to work on strengthening a weak position and then applying it to the main lift, or to work on two separate pieces of the lift. For example, let us say that an athlete has the hips rise faster than the bar out of the hole. In those sets of 8 I could keep telling the athlete to keep the chest up and hope that they make the adjustment.

The problem is that often times we are not strong enough in that position to hold technique, or we do not have the appropriate motor control. If we break it up we could start with a 4×4 of a 2 second pause on the halfway up in the squat. We then could take a break and bench and then come back squat. Upon returning to the squat we can put what we learned about staying tight out of the hole and focus on improving that in the competition lift itself. This is a much better use of the total volume in a training day in my opinion.

Some will say that you do not need variation and you should practice your sport all of the time. I do agree that we need to practice the sport. The problem with only performing competition lifts is twofold. For one, many times the lifter is not strong enough in the weak position of the lifts to maintain position under heavier loads. We need to strengthen these positions. Pauses at the weak spots work very well here.

Also, there is what is known as adaptive resistance. If we go into the gym and perform the same movement over and over, it becomes more and more difficult to improve upon technique. Our body basically settles on a way to perform the lift. Adding in variation allows learning to continue to improve on each lift. In the offseason 20% of our volume should be competition lifts and 60% should be variations.

As a meet approaches, those percentages change as we want to perform more competition lifts to maximize our technique for the meet. Once the meet is done, we go back to performing more variations to continue on working on those weak spots.

No matter who you are, you have weak spots in every lift. There are positions in every lift that we have less leverage to complete the lift than other parts. For example, just below the knees on a deadlift. We have less leverage here than any other spot of the lift. Performing reps to the knees and pauses at the knee can help strengthen that area so your deadlift can continue to progress. If we do not focus on these areas of less leverage it will be difficult for them to keep up with weight being added to the bar, and this can slow progress.

With all of that said, I am not hating on sets of 8 or more. They definitely have their place in a well laid out program. Sheiko tends to put reps of 5 or less between the larger sets to allow for recovery and technique to stay sharp. This is a way to get a high volume day in a lift without a break. This helps build work capacity.

I tend to not program deadlifts in this manner and keep those reps as 5 or less just to keep the lifter safe. The deadlift is also the toughest of the three lifts to recover from, so higher rep sets just may be too much to allow the lifter to recover and finish the set with good technique. This fatigue could also carry on into other training days.

We do not always do double sessions of competition lifts. Scheduling lighter days are important for fatigue management. There may be a whole week without a double session to allow for the athlete to recover from higher volume weeks.

Lastly, the breaking up of volume into two sessions allows us to do more volume over time. With the break in the middle, we recover enough to be able to complete maybe an extra set of volume. Over time this really adds up and can make a huge difference in our progress.

On this episode of the podcast, we have guest Elle Russ. Elle Russ is a writer, actor, health/life coach, and host of The Primal Blueprint Podcast. As the author of The Paleo Thyroid Solution, she is becoming the leading voice of thyroid health in the burgeoning Evolutionary Health Movement (also referred to as paleo, primal, or ancestral health). Elle has a B.A in Philosophy from The University of California at Santa Cruz and is a certified Primal Health Coach. She sits on the advisory board of The Primal Health Coach Program created by Mark Sisson, bestselling author of The Primal Blueprint. Originally from downtown Chicago, she lives and plays in Malibu, CA. You can learn more about her at http://www.elleruss.com.

30 Day Guide to the Paleo Diet

Want some extra help? Have you been trying Paleo for a while but have questions or aren’t sure what the right exercise program is for you? Or maybe you just want a 30-day meal plan and shopping list to make things easier? We’ve created a getting started guide to help you through your first 30 days.

The internet was an incredible invention. It allows us to connect with people all over the world. In terms of strength and conditioning it has been amazing as well. It allows information to be readily available to us at our fingertips. It has also allowed me to work with one of the greatest powerlifting coaches ever, Boris Sheiko, when he resides in Russia.

With that said it does have some downfalls. It allows everyone with an Instagram or Facebook account to be an expert in any field they choose. The internet is filled with hundreds of world record holding online coaches. This can lead to some confusion for the person that just wants to get a little bit stronger.

I have noticed recently that a lot of strength athletes tend to jump from program to program. These are not just beginners, but elite athletes as well. If you are one of these people that tend to jump from program to program, I encourage you to read on.

No matter who writes the program, it has to abide by certain scientific principles to be effective. For one, it needs to be specific to the sport. If you are a powerlifter, spending endless time on training your biceps is a waste of time, as they do not contribute much, if anything at all, to a larger squat, bench press, or deadlift.

The program needs to be specific to your goals. The program also needs to create enough of a stressor that allows you to put on more muscle mass and to prepare the nervous system to move maximal weight. This principle is known as the overload principle.

Basically, over time you need to continually increase the volume and intensity to keep progress moving forward. Often times I will hear people say something like “Sheiko did not work for me” or “I got injured running a Sheiko program.”

It was not the program that was ineffective. These programs were not written for that individual. The volume may be too little or too much which would result in a program that is ineffective, or one in which the athlete cannot recover from.

Determining an individual’s appropriate volumes and intensities is no easy task, and it is a process. We are all our own unique little snowflakes. We could even take two similar athletes in size, strength, age, and anatomy and have two very different abilities to recover based upon genetic makeup, sleep, nutrition, and stress.

If you decide to work with a coach and they do not look at what you have been doing previously to help them understand where the volume needs to be, then perhaps they are not fit to be a good coach. If the coach does not analyze the volumes and intensities that the athlete has been training with, then how can they appropriately apply the overload principle? They can’t, and it is nothing more than a guess.

I use the Russian Strength Classification chart as a guideline of picking volumes. This chart places you in a category based upon your total in the big three lifts. Depending what category someone falls into, I have a range of volumes I look at. Why is this any better you may ask?

Certain skills need to be developed in order to hit those numbers for a total. The higher the total in a weight class, the greater the muscle mass and nervous system abilities of the athlete. This does not paint the whole picture however. This is just a starting point.

From there, I look at what the athlete has been doing for the last month or more. When I analyze the program that they have been doing, I calculate the average daily, weekly, and monthly volumes, as well as the average intensity lifted in each competition lift and competition variation. This is a lot of work, but necessary for the future success of each athlete.

This is also why cookie cutter programs are ineffective. They may work for some people, but not everyone requires the same volumes and intensities to get stronger. On top of all of that we look at technique. If technique is poor the average intensity will be on the lower end of the ranges, and maximizing technique will become a primary goal.

In over ten years in this field I have had my toes stepped on quite a few times. I have even had other “coaches” send me what they think my athletes should be doing. I have even received Excel spreadsheets with weeks laid out. They did this without clearly understanding the scientific principle of overload because, in one of the more recent ones, the volume was about 80 lifts below where my athlete was training previously.

The program should include enough variation to allow progress to keep moving forward, but enough work within the competition lifts to increase skill level. In general I program 20% competition lifts and 60% competition lift variations such as pauses and the like. This I took from Sheiko. I was told early in my career to mimic those that have done it best, attempt to understand why they do it that way, and finally to adapt and improve upon it. This is why I started working with him over a year ago.

If you have too little variation within the program, we run into adaptive resistance. This even applies to technique. If you do the same thing over and over again it becomes more and more difficult to make the necessary adjustments, as our nervous system has adapted to performing it in a given way.

However, if we step away for a while and come back to it, our learning can continue. For example, Louie Simmons out of Westside Barbell may have his guys run a 4 week cycle only using the safety squat bar. When his athletes go back to the straight bar, it may feel a bit off, but that “relearning” of the lift allows progress to carry on in the long term.

Strength training is filled with peaks and valleys. However, we want to make sure each peak is higher and higher so that over time we are seeing constant increases in our total. As coaches we do this from constantly analyzing, assessing, and making the necessary changes to the program over time.

Often times people will choose to work with a coach because they have a big total. We think “Well he is strong as shit so he must know what he is talking about.” Not to take anything away from getting educated under the bar, as I feel this is extremely important. However, buyers beware. What worked for that individual may not necessarily work for you.

I am not that strong, but having a master’s degree in the field, I have a good understanding of how the principles work. I also get under that bar 4 days a week and train as hard as I ask my athletes too. I have worked with the same coaching staff since day 1 of my powerlifting “career.” I will continue to work with this coaching staff for all of the reasons I stated above.

Sheiko has analyzed my volumes and intensities for over a year. I understand that to be where I want to be in the strength sports that it will take time. Changing my shoes, where I grip the bar, sumo or conventional or low bar vs. high bar does not matter at this point. To get stronger you need to put in work. You can’t drop the bar an inch lower on your back, or spread your feet wide on a deadlift and expect to just blast out a bunch of PRs. These things may be important, but hopefully you have a coach that understands all of this and that knows your strengths and weaknesses as a lifter.

No change in coaches is going to just magically make you stronger. This is especially true if those coaches do not fully understand the scientific principles of getting stronger. Do your research, ask good questions, and find a coach that you know you can work well with and stick with them. Put in the work that they ask you to and you will be better off in the long term. The athletes at the top have put in decades of work in the sport. There are no shortcuts to the top.

Regrarians have made a film about Polyface Farm, a third-generation farm in Virginia’s Shenandoah Valley, that shows us how to regenerate our landscapes, communities, local economies, health and most importantly, our soils!

Polyfaces: The Film is full of inspiring examples of how we can do all this whilst keeping families on farms, producing quality, nutrient-dense food, working with nature w hile encouraging and supporting a whole new generation of farmers!

Small-scale farming is changing our communities, our land and our lives for the better. This film captures the dire need for mass agricultural change on a global level and how we can choose to employ positive, solution-based strategies to empower people to make more informed consumer decisions & change the way we eat, buy & grow food, forever.

Your support of this film goes towards having it translated into as many languages as possible, so we can widespread this hopeful & regenerative future we know is possible.
Polyfaces is available now, Click HERE for DVD, Streaming & Community Screening purchases.

This week we have guest Elijah Markstrom. Elijah is a personal trainer, health and fitness nut, and Spartan and obstacle racer. Listen in as we chat about diet, nutrition, ketosis, gut microbiome, Spartan and obstacle racing, and more.

30 Day Guide to the Paleo Diet

Want some extra help? Have you been trying Paleo for a while but have questions or aren’t sure what the right exercise program is for you? Or maybe you just want a 30-day meal plan and shopping list to make things easier? We’ve created a getting started guide to help you through your first 30 days.

This is for you if:

Your coaching or clinical practice is not as profitable as you would like

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We have moved far away from having the instinctual ability to know exactly how to feed our children. There are hundreds of books trying to teach us the right things to do. The media tries to shout out at us! The norm in our ‘rush rush’ culture is quick and easy. We see the word ‘healthy’ and we take it and run with it. There is this parent guilt we experience, associated with anything cheap and fast. Flashy advertisements labeling everything from breakfast cereals, to power bars, to chicken nuggets as ‘healthy’ ‘all natural’ and a must have part of our child’s nutrition. My point here is that feeding children is no easy feat! But we do it. We feed our children as close to a paleo paradigm as we can, within the context of our modern culture. We feed them within the realm of soccer practices, late meetings, playdates, carpools, and needing to be 20 places at once. Are you that parent who doesn’t buy cereal or boxed foods? The parent who spends quite a bit of money every week on groceries, and time to prep kid-friendly meals, in order to feed your child your best version of healthy that you can possibly muster? Are you that parent who, despite your attempts, your child still struggles with his/her weight, food allergies, autoimmune issues, frequent colds or even chronic ear infections?

Modern children are the cultivation of generations of consumerism. The emerging science of epigenetics is showing that not only are genes inherited from parents, the diet and lifestyle of your parents, grandparents and even great-grandparents has a profound impact on your health, your children’s health, and even their children’s health. You may have the most perfect diet, and yet still have a child with food allergies, autoimmune issues, and metabolic struggles. With the onset of the agricultural revolution, and the slow rise in processed foods becoming the standard, came about a dramatic increase in inflammatory related illnesses and metabolic issues. It becomes more and more difficult to undo generations of misguided nutritional advice. With commercialism and media telling us what we should be eating, we are in a sense, set up to fail. It takes a great deal of effort, and yet sometimes our best attempts may not be working for us. Processed foods are the norm for most families now. Even the most well advised parents are seeing their children put in situations where processed foods are the only option.

Modern children are different, and we have to look at the bigger picture. It’s not only about nutrition. They are exposed to more environmental toxins, there is less movement throughout the day, with a higher emphasis on achievement in school, stress is higher, life is faster. Mode of birth and breastfeeding, as well as hospital practices that undermine the birth process are affecting our children’s microbiome. My point is that there are a great many factors that can contribute to childhood obesity. Although diet plays a major role, it’s not only about food here. In this piece we will discuss the impact of nutrition, movement, and microbiome on childhood obesity.

Nutrition

In their book Pottenger’s Prophecy, How Food Resets Genes for Wellness or Illness, Gray Graham, Deborah Kesten, and Larry Scherwitz discuss the concept of epigenetics. Epigenetics is the relationship between our genome and the environment with regards to aging and disease. It’s a very new science, however quite promising in helping the medical community understand the impact our inherited genes, diet, lifestyle, and environment have on both our own health and the health of our offspring. Graham discusses Dr Francis Pottenger, a pediatrician and research scientist in the 1930’s. His research on cats lays down a foundation for understanding how nutritional deficiencies from a modern diet can be passed down to the next generation, as well as generations to follow! Pottenger studied generations of cats by giving some of the cats a raw and natural diet, and some of them a cooked and processed diet. He studied their births, pregnancies, and conditions that humans are prone to such as illnesses, heart conditions, thyroid disease, and inflammatory processes.

According to Graham, there were two fairly remarkable conclusions drawn from Pottenger’s study on cats. The first being ‘physical degeneration caused by a poor diet in the mother is inherited in the offspring and passed on through the third generation.’ and the second being, ‘When a mother’s diet is nutritious, not only does she benefit with good health, so, too do her offspring…and their offspring, and so on.’

What does this mean for us? It’s imperative that our generation stop making excuses for poor nutrition, and start making some big changes. It may take a few generations for the health of our future generations to return, and for disease processes like autoimmune conditions, metabolic issues, and asthma to start reversing. We may still have children that struggle, but we have to look at the bigger picture and start incorporating major changes.

There is this fear that our children will have a disordered view of food, if we are ‘overly healthy’ with them. In my opinion, this fear of disordered eating is pulling us too far in the opposite direction. The real disorder, is what we now consider normal. The food industry perpetuates this fear, by leading us to believe that moderate amounts of processed foods labeled as ‘healthy’ are okay for children to consume. Avoiding giving our children packaged foods, is viewed as dysfunctional by many who follow mainstream nutrition paradigms. However, The best thing we can do is make real, healthy home cooked food a priority at home. Make it normal. Everyday. There are many amazing kid-friendly blogs and cookbooks. There are crockpot recipes and meal plans. We can get our children involved with meal prep, and get them excited about real food. Keep in mind that what they are consuming now will have a profound effect on their offspring, and the subsequent generations to follow! We are in a sense changing their genes for the better, through real food. One bite at a time, one meal at time.

Movement

With the onset of modern technology and increased screen time, modern children are not moving nearly as much as they should be throughout the day. On top of this, our educational culture has moved in the direction of achievement at all cost. Children are spending 6+ hours a day sitting in the classroom. Recess time is becoming less and less. Movement throughout the day (not just during structured sport settings) is essential for a child’s physical and emotional well-being. A recent study published in Applied Kinesiology, Fitness and Metabolism (2016) looked at why children are more sedentary now. The biggest factor was increased screen time at home. These researchers concluded,

‘The most common correlates included weight status and access to electronics in the house’.

We need to have our children step.away.from.the.screen. Literally. Free play is a lost art, yet necessary for our children’s mental and physical wellbeing. As parents we need to speak up about the importance of movement throughout the day at school. Speak up about more recess. Speak up about stretch breaks throughout the day. Sitting all day is extremely counterproductive for children. Play and movement are so imperative for instilling in our children!

‘Our children are the most sedentary in human history with physical activity becoming increasingly optional and our kids suffering the health consequences of this inactive lifestyle. Movement should be mandatory – you can’t outrun a poor diet, but you can’t ‘healthy eat’ your way out of a sedentary lifestyle either. Create the environment to ensure kids have fun with movement.’

When at home, limit screens, and focus on outdoor free play and movement as often as possible throughout the day. We need to get our children back outside, and back to using their bodies throughout the day.

Microbiome

Within the past few years there has been a great deal of microbiome research, with regards to obesity. One major factor is mode of delivery at birth and breastfeeding! Children born vaginally are at a decreased risk of obesity, and this is because of the beneficial bacteria the infant is bathed in when passing through the birthing canal. One very recent study by Yuan, Gaskins, & Blaine, et al. (2016) concluded that cesarean birth was associated with offspring obesity after accounting for major confounding factors. In within-family analysis, individuals born by cesarean delivery had 64% (8%-148%) higher odds of obesity than did their siblings born via vaginal delivery. There are, however, ways we can incorporate microbiome into our birth plans.

A review of research in Nature Reviews Microbiology, suggests that microbiome should now be a part of our birthing plans.

‘Delivery by C-section has been associated with an increased risk of immune and metabolic disorders, which are thought to arise owing to changes in microbiota’

Researchers exposed babies to vaginal fluid from their mothers within the first two minutes after cesarian. They observed that their microbiome composition resembled the microbiome of vaginally delivered infants throughout the first month of life. Other important ways to increase an infant’s healthy microbiome at birth, are skin to skin contact with parents immediately after birth, not bathing the infant, and breastfeeding.

Another huge impact on children’s microbiome is associated with germ theory, and the overuse of antibiotics, antibacterial hygiene products, and general societal fear of children getting dirty. This is in of itself a whole new topic that can fill a book. In a nutshell, we are essentially killing off beneficial bacteria, and not exposing our children to microbes necessary to build up their immune system. My biggest suggestion is to not fear dirt! Let your children play in the dirt. Let infants explore their world with their hands and mouth. Stop over-sanitizing everything, and fearing all bacteria. It’s time we realize just how important a little dirt is, in terms of shaping our child’s collective microbiome.

There are many other factors that come into play when it comes to childhood health, that just couldn’t fit into this one piece, including emotional health, stress, sunlight, and sleep.

What are some simple steps you can take now with your child?

We are bombarded with media telling us what we should be buying, and doing to better our children. We need to step away from all of this. Let’s instead make small and concrete steps towards bettering our children’s health, such as:

Meal plan, and focus the majority of meals around real food.

Limit screens, get your children outside playing, even on very cold days. Stop fearing the elements. Get them outside.

Have a microbiome plan in your birthing plan.

Allow your children to explore the world, get outside, and get dirty!

First and foremost, understand that your child’s health struggles may be due to a variety of compounding factors, including how his/her great grandparent’s lived. Keep in mind modern children are not the same as even the last generation.

LeBlanc, A (2016). Why are children sedentary: an examination using the International Study of Childhood Obesity, Lifestyle and the Environment. Applied Physiology, Nutrition, and Metabolism, 41(7): 790, 10.1139/apnm-2015-0555.

Kathryn is a Nutritional Therapy Practitioner (NTP), who specializes in healing leaky gut and overcoming autoimmune diseases. She sees clients locally in her Ballston Spa NY office, and also offers worldwide phone and skype consultations. Kathryn is a blogger at www.primalblissnutrition.com. Kathryn is mama of two boys and is passionate about feeding infants, toddlers, and children real food. In her spare time Kathryn enjoys CrossFit, hot yoga, bass fishing, hiking, and wrestling with her boys.

As you might know, Robb and I are HUGE fans of The Savory Institute. He and I were both invited to their recent conference in Boulder. Robb had another event he was committed to, but I hopped on a plane and was so thrilled to be a part of if.

I have to say it was one of the best conferences I’ve attended. As a bonus, the day after the big event, I got to visit a bison ranch that practices holistic management. Having never seen bison up close before, this was a real treat. The mix of attendees was fascinating. I had a chance to speak with ranchers, marketers, and venture capitalists who are all deeply interested in the work of Allan Savory (if you haven’t seen his famous TED Talk, check it out here.)

Bison grazing at West Bijou Ranch in Strasburg, Colorado

Allan talked about how he’s in the “departure lounge.” This may sound depressing to you, but coming from him, it was sobering yet inspirational. He said he’ll never see the full results of what he’s started, and how important that is. The other folks I spoke with at the conference all had the same mission in life: To be part of something so big, that they will never fully see the results. I think that’s why I loved being there. In the world of quick profits, keeping up with the Jonses, and shallow, short-term goals, I can sometimes feel discouraged. It’s not often that I am surrounded by people who are passionate about a long term vision of creating a better future.

The folks at Savory have been working with i.e. Media to produce a series of incredibly high quality short films that illustrate how holistic management can dramatically reverse desertification and regenerate not only the soil, but whole communities. The films were revealed at the conference and are being released one by one. In my opinion, film is absolutely the perfect way to illustrate the effects of holistic planned grazing. You have to see it to believe it, and the crew did an artful job of telling the story. To me, it’s much more powerful than any other media, especially in the story of sustainability. Some of my favorite companies were featured, like Maple Hill Creamery (you can see them in the dairy episode) and Epic Provisions, who are featured the “Story of Meat” here.

Rancher Will Harris and Taylor Collins from Epic Provisions talk about how they were connected through The Savory Institute

At the end of the conference, they revealed their Land to Market Program. The goal is to empower consumers to know which products are healing the environment as a result of how they were produced. This verification is outcome based, where farmers and ranchers have to scientifically demonstrate, with empirical data to back it up, that they are rebuilding broken ecosystems.

I also had the chance to speak the following week at the the Agrarian Learning Center in Hudson, New York as part of the Savory Hub events. I was joined by Seth Itzkan, Co-founder and Co-director of Soil4Climate, Shannon Hayes, author of several books including my favorite Radical Homemakers, Dairy farmer Phyllis Van Amburgh, who runs dharma Lea, and the folks from Maple Hill Creamery. I gave a short presentation about the how we need to be eating more protein, less CAFO chicken, and stressed the nutritional importance of consuming meat and dairy sourced from holistically managed farms.

I can’t tell you how much I believe in the work of The Savory Institute and am thrilled to support The Land to Market Program. Some people are able to connect directly with their food producers but most are not. There’s currently no good way for consumers in traditional stores to discern how their meat was raised. There’s a big difference between well-managed meat and simply “grass-fed,” which could simply mean the animal was on the same, overgrazed paddock every day. I’m particularly excited about their verification for fiber and leather. It was eye opening to learn how many hands are involved in the supply chain, and how there’s currently no way to tell if your sweater or handbag is made from well-cared for animals.

It’s time we have the tools to make better decisions about our food and fiber products. It’s also time producers have access to consumers looking to pay a premium for better management practices.

The Land to Market Program will enable producers to gain access to new markets and premiums above commodity pricing, and will take the guesswork out of things for consumers, to allow them to connect with not only the products they believe in, but the people behind them as well. The goal is to celebrate the boots-on-the-ground, frontline soil-saviors while at the same time spotlight the countless working-class men and women who deeply desire to shop in a way that supports those folks.

This program won’t simply tweak a few things in how our food and clothing supply chains work, it will take a sledgehammer to them. The true cost of fast-food and fast-fashion are expended in unseen externalities to our local communities and our environment. There is rampant exploitation of our land, animals, and people, taking place on a global scale.

The best way to facilitate this change is to create a consumer demand through story telling and their verification process. This is why I fully support the Land to Market Program.

They’re running a crowdfunding campaign on Indiegogo right now, and if they reach $30K from 50 different donors in the next few days, Indiegogo will promote their campaign to their entire mailing list and feature The Savory Institute on their homepage. I encourage you to support them in their efforts to bring food and fiber from producers who practice the gold standard of land management practices to consumers who are excited to buy them.

]]>http://robbwolf.com/2016/11/17/food-and-fiber-the-consumer-revolution/feed/2How Much Protein/Meat Are We Actually Eating?http://robbwolf.com/2016/11/15/how-much-proteinmeat-are-we-actually-eating/
http://robbwolf.com/2016/11/15/how-much-proteinmeat-are-we-actually-eating/#commentsTue, 15 Nov 2016 13:00:15 +0000http://robbwolf.com/?p=19614Continue Reading]]>In my previous post, I illustrated that the optimal intake of protein for a healthy person on a 2,000 diet is about 100 grams or so, which is nearly double the RDA. Keeping with the theme of “Are We Really Eating Too Much Meat?” I’m going to look now at how protein Americans are eating, then I’ll look at how much meat Americans are eating from a few different data sources.

1. How Much Protein Are We Actually Eating?

Answer: Not enough.

According to NHANES, which uses 24 hour dietary recall surveys, the average woman eats 1825 calories a day, with 16% from protein, 49% from carbs, and 34% from fat. Men eat 2477 calories, with 16% from protein, 47% from carbs and 34% from fat. (note: these numbers are lower than other estimates, probably because people like to lie in dietary surveys.) This self reported data says on average, men are eating 2477 calories a day, and women are eating 1825 calories per day. Men and women are eating about 16% of calories from protein, at the low end of the ADMR range of 10% – 35%. This source (coincidentally, written by Robert Wolfe) also puts protein about 15% and also criticizes the RDA for protein for being too low.

If you read my previous post about human protein needs, I explain the recommendations for protein vary greatly, but in general, at least 20% of calories from protein is a good goal. Protein is the most satiating of the macronutrients, and intakes of 15% – 30% of caloric intake can be quite helpful in regulating appetite by increasing leptin sensitivity and inducing weight loss and increasing blood sugar control. In this meta-analysis, high protein diets of 25% – 32% of calories compared to the control groups of 15% – 20% (which is still higher than the RDA), showed beneficial effects on weight loss, HbA1C levels and blood pressure in patients with type 2 diabetes. Also, I do think there’s something to the protein leverage hypothesis – increase the percentage of protein in the diet and total caloric intake actually goes down – especially when you pull out the soda and other junk food. This post highlights two studies looking at relatively high protein diets, showing them successful regardless of carbohydrate or fat intake.

2. How Much Meat Are We Actually Eating?

Answer: It depends on what data you’re looking at, and what you consider “meat.”

Some of the information out there only counts “red meat” as “meat,” leaving out chicken, seafood, eggs and milk. Other data may include chicken but leaves out seafood. Some numbers are based on meat “availability,” meaning ALL THE MEAT PRODUCED (including non-edible parts), while other numbers factor in “loss” (what’s trimmed off at the slaughterhouse, loss in the grocery stores, loss in homes.) So, as you can see, the real number is quite difficult to obtain.

Meat as % of Calories, Based on Food Balance Sheets

National Geographic developed a series of great interactive charts that show caloric consumption by country and broken out by category and food type. Their data is from the FAO, which uses “Food Balance Sheets,” to estimate food consumed, also based on availability and adjusted for loss, however the FAO admits that this is not a completely accurate picture of actual consumption. According to their charts, the average American eats a daily total of 3641 calories, (or, at least has access to 3641 calories) which is a much higher number than the NHANES number of 2141 average daily calories per American.

I personally have a hard time with the large discrepancy between the FAO (food availability) and NHANES (self reported) caloric intake numbers. The FAO total number of calories (3641) seems much higher to me than what people are actually eating. The charts here also show 373 calories from milk, that would be 4 cups of milk per day, equaling about 30 grams of protein. Also, at 469 calories of meat, this would mean we’re getting about 120 grams of protein per person, which I doubt. Add in the milk, and this increases our total protein intake to 150 grams a day. I’m just not convinced we’re actually eating this much in total calories, or this much in protein, and question the accuracy of their loss adjustment – it doesn’t seem realistic.

However, looking at this data, it shows our total meat intake is 13% of our total caloric intake, and the dairy & egg category is 14%. By percentage, this number could be more realistic — Although the FAO says they adjust for loss, and their meat doesn’t include livestock feed, it does include things like pet food, which includes a lot of meat, so I’m not buying these numbers as fact.

What does seem to make sense is the meat availability by tons (meaning total production) to give a sense of how our production has shifted. When looking at total tons available, over the 50-year span, chicken availability has increased 421% in the United States. Worldwide, chicken production has increased over 1,033%, while worldwide beef production has remained flat, 0%.

USDA Meat Availability Charts

Similar to the FAO, the USDA looks at meat availability. There is one big number that many meat-phobic folks like to use for per person meat consumption: 250 pounds per year. I’ve even seen many “real food” folks cite this number in an argument that we need “less meat, better meat.” This gigantic number comes from the USDA meat availability chart, which in the case of red meat, includes the whole carcass (bones, kidney, attached internal fat,) and for chickens, includes skin, fat, liver, gizzard and neck. This sounds like we’re eating 11 ounces of meat a day, but this is based on what’s available, not what’s actually consumed.

The USDA has a different set of numbers when adjusted for loss (what’s removed at the processor, loss at the grocery store, loss in homes), to estimate what actually is consumed.

This data shows only 27 pounds of chicken per person in 1970 compared to almost 60 pounds per person, per year in 2014. Not only are we eating more chicken, but we’re eating more sweeteners, grains and a lot more oils today. When you add total red meat plus poultry and seafood, the number is 134 pounds per year, only 0.36 pound per day. That’s 5.76 ounces of meat. This is exactly the recommendation of the US Dietary Guidelines “My Plate.” I think 0.36 pounds of animal protein (not eggs or milk) per day is much more realistic for what Americans are actually eating, on average. This would be about 45 grams of protein from meat per day.

We’re Eating Too Little Protein; Not “Too Much” Meat

To summarize, we’re eating a very low amount of protein, about 16% of total calories. It should be at least 20% of caloric intake, which means at least 100 grams of protein on a 2,000 calorie diet. When looking at meat consumption, it’s important to account for loss; from “availability” (carcass weight, pet food, other non-edible outputs from meat processing) to what actually makes it home to the consumer and into our bodies. There seems to be no incredibly accurate ways to tell exactly how much meat we’re eating, but the number is likely between 5 and 6 ounces per day, which is consistent with what the US Dietary Guidelines recommends, and is too low compared to the ADMR. Americans (and the rest of the world) are eating a lot more chicken than ever before. We’re also eating more grains, sweeteners, and vegetable oils.

Takeaways

We’re getting sicker and more overweight each year in America. We need to eat better food, and less of it in total. In order to reduce obesity, increasing protein and reducing grains, sugars, and vegetable oils (this means reducing intake of processed foods) is the right way to go. When choosing the right sources of protein, I argue that beef (and other herbivores like lamb, goats and bison) are better choices from an environmental and animal welfare perspective than other sources of animal protein. Animal protein is also a much more efficient source of protein from a caloric perspective than consuming protein from vegetarian sources, which I will dive into in my next post. We’re not eating too much protein, nor “too much” meat. We need less food, better food. Next, you’ll learn what proteins are optimal for human health, animal welfare, and the environment.

This week we have guests Matt Pendola and Bobby McGee. Matt Pendola is the founder of Pendola training, a high level endurance coach, and an accomplished runner and cyclist. Bobby McGee is a six time Olympic running/triathlon coach and has been involved in endurance coaching for 32 years. Join us as we talk about performance mindset, training, coaching, endurance, strength and conditioning, and a lot more from some very knowledgeable coaches.

30 Day Guide to the Paleo Diet

Want some extra help? Have you been trying Paleo for a while but have questions or aren’t sure what the right exercise program is for you? Or maybe you just want a 30-day meal plan and shopping list to make things easier? We’ve created a getting started guide to help you through your first 30 days.

This is a topic near and dear to my heart. I have been hesitant to share this condition because it honestly scared me to death when I first learned about it. In time, not only have I healed, but the more I understand the condition the more empowered I become to prevent it from coming back.

This is a lengthy research report, so bare with me as the details are important. I will describe the condition leaky gut (or increased intestinal permeability), how it is linked to your immune system, why it matters, causes and solutions.

Leaky gut is more specifically described as increased intestinal permeability. It is a descriptive term related to the small intestines having a reduced barrier function. This condition is not a diagnosis alone, but has been linked to many illness and symptomology.

The small intestines allows properly digested fats, proteins and starches to pass through the cells in order to be used by the body while providing a barrier to keep out foreign substances, large undigested molecules and bacterial products. Gastrointestinal mucosal lining and microscopic villi (little hair like tentacles) provides the barrier function of the small intestines. In between the epithelial cells are tight junctions held together by the junctional complex. When the junctional complex is disrupted, the epithelial cells separate and allow particles into the body without policing them. Once the particles enter the body, the immune system recognizes those particles as foreign (an antigen) and stimulates an antibody reaction.1

This patency of the small intestines provides a direct access to our cellular immune system. The antigens (either dietary related or microbial or viral) pass through the weakened junctional complex(JC), they are presented by an antigen-presenting cell (APC) to the T-cells (a lymphocyte produced by the Thymus gland). 1

This is your direct access to the cell-mediated immune response as well as inflammatory response. Below is a figure of the process of the antigens getting through the leaky gut wall and the immune response.

(Nutrients, 2013 de Punder)

How do you test for this condition?

To officially test for intestinal permeability, the standard is to perform a lactulose/mannitol test. One would ingest the permeability marker orally (lactulose/mannitol) and then measure the contents in the urine. 2 Other permeability markers have been tested in a mice model including FITC-dextran 400 and ovalbumin measured in the plasma as well as polyethylene glycol measured in the urine. All oral permeability tests have been shown to be suitable in assessing intestinal barrier function. 3

Once intestinal permeability is increased and a leaky gut is present, the antigen enters the body and stimulates the cell-mediated immune response. It is important to understand, at this point, the symptoms related to this response could be anywhere and dramatically vary from individual to individual and day to day. Another indicator of increased intestinal permeability/leaky gut is any one or more of the associated symptoms or clues4:

Abdominal pain

Anxiety

Asthma

Bed wetting

Chronic joint pain

Chronic muscle pain

Confusion

Constipation

Diarrhea

Fatigue

Fevers

Fuzzy thinking

Gas

Indigestion

Poor immunity

Poor memory

Recurrent Bladder Infections

Shortness of Breath

Toxic feelings

This intestinal permeability condition has been linked to many diagnoses as a potential contributor to the disease process. It stands to reason that there may be a cause and effect relationship, but that continues to be the debate. Here are a few diagnosis that have been linked to increased gut permeability:

Many more conditions have been associated with a leaky gut. To be honest, I began to run out of time to validate each condition. The reality is that research continues to elucidate this topic.

What I am particularly interested in is to understand what CAUSES the small intestines to become “leaky” and setting up the immune response, which may correlate with disease. I will address four categories related to cause based on the soar principles of Eat Well, Move Well, Sleep Well, and Soar On.

Food Causes

It should be of no surprise to anyone reading this, if you follow my blog, that the first food component I will address is wheat and gluten containing grains as a cause of increased intestinal permeability. Gliadin is a gluten protein contained in wheat and other grains like rye and barley that have been targeted in celiac disease(read more here http://www.renosoar.com/holistic-health-tips/to-eat-gluten-or-not-to-eat-gluten-that-is-the-question).

A recent published study took biopsy specimens from small intestines of adult subjects undergoing an esophagogastroduodonscopy (EGD) for various reasons. Each subject was categorized as either a celiac patient with active disease (ACD), celiac patient in remission (RCD), non-celiac patient with gluten sensitivity (GS), and non-celiac control (NC). Each biopsy was incubated with gliadin or media alone. The researchers found that all biopsies demonstrated increased intestinal permeability in all groups in the presence of gliadin. However, the greatest increase occurred in the samples from the ACD group, which was no different from the GS group. 18

The proposed mechanism is related to the disruption of the junctional complex described above via the zonulin pathway as a direct result of the presence of gluten proteins, not just the presence of intestinal inflammation. 19 What I find of particular interest regarding the gluten grains is that despite their link to increased intestinal permeability and a variety of symptoms that those grains remain difficult to give up for many without a specific celiac diagnosis. It has been proposed that gluten grains may even “mask” their own toxicity by having an opioid effect. The gluten can be degraded into morphine-like substances called gluten exorphins. These compounds could cover up the deleterious effects of gluten on the gastrointestinal lining. 20

Basically, gluten-containing grains may act like addictive drugs.

Unfortunately, the food causes of increased intestinal permeability do not stop with gluten-grains. In a mouse study evaluating the growth of intestinal tumors compared high fat diet (defined as 45% of fat calories) to a normal diet (defined as 15% of fat calories) composed of corn oil and lard. The high fat diet had increased oxidative stress as well as an increased membrane permeability of the intestinal lining via the zonulin pathway. 21 I have spoken to healthy fat in the past. Corn oil is considered an unstaturated fatty acid that can become trans when heated as it is unstable. As compared to lard which is more heat stable and in moderation and sourced optimally can be health promoting. These points may be potentially important in the case of intestinal integrity because not all fats are created equally. See more here on (http://www.renosoar.com/holistic-health-tips/fat-is-it-really-health-promoting)

Another food like substance that is associated with increased intestinal permeability is food additives. Processed foods are high in food additives to optimize texture, color, sweetness, taste and shelf stability. Specifically, glucose, salt, emulsifiers, organic solvents, gluten (again;)), microbial transglutaminase and nanoparticles (very small) have been tied to increased intestinal permeability by breaching the junctional complex. 22 This is particularly problematic for children that consume prepackaged snacks for convenience sake morning, noon and night. This unfortunate habit common for parents puts them at an even higher risk for incidence of autoimmune diseases and any of the above-mentioned diseases.

Exercise Causes

Most would consider exercise in nearly all ways, beneficial. Yet, I found an interesting correlation with increased intestinal permeability in heavy exercise and exertional heatstroke. In a study of 8 healthy male subjects that were regular exercisers were subjected to 20 min of constant speed on a treadmill equivalent to 80% of VO2 max as determined per each subject. Within 5 min of the run, they were subjected to an oral intestinal permeability test. This workout was associated with increased permeability. 23 Later we will discus their protocol to decrease the intestinal permeability.

Heatstroke is considered catastrophic as a result of heat-related illness and is most common in a younger person engaging in strenuous activity in a warm environment. The stress of the exercise in a hot environment will reduce the blood flow to the intestines and promote a reduction in the junctional complex resulting in increased permeability and other local and systemic inflammatory reactions that result in endotoxemia. 24-26 This condition is rare, but the consequences may be deadly. This extreme exercise condition however, is a cause of increased intestinal permeability.

Another component that I am putting in this category as it relates to movement outside in the sun. Vitamin D is produced naturally with the UVB rays hitting the skin and converting cholesterol into Vitamin D. In today’s world, Vitamin D deficiency is more and more prevalent. Vitamin D is not only important in modulating the immune system, but it also protects the mucosal barrier of the intestines. In a mouse study comparing Vitamin D rich diet or deficient diet, they found that Vitamin D provided a strengthening of the intestinal epithelial wall against infections that are known to increase permeability like E. Coli. 27,28 Although it is not a direct causal effect on intestinal permeability it appears that Vitamin D deficiency reduces the resistance to developing leaky gut in the presence of an infection like C-Diff.

Sleep Causes

As I have described in the past, our sleep patterns are regulated by our circadian rhythm. Disruption of the circadian clock has been associated to many disorders, now to include a disruption of the intestinal epithelial barrier. A mouse study used an alcohol induced leaky gut model and found that disruption of the sleep-wake cycle promoted further gut leakiness in the mouse. 29

Interestingly, in a human study evaluating intestinal permeability in night shift workers with day shift workers that alcohol consumption did not alone induce intestinal permeability. However, they found that the night shift workers had elevated inflammatory markers and an increased risk for developing intestinal permeability in the presence of alcohol. The sleep architecture played a role in developing a higher risk for increased intestinal permeability in the presence of social drinking. 30 There is speculation that the circadian genes control the expression of several genes involved in regulating intestinal permeability and that can be induced by alcohol. 31

Soaring Causes

The fourth principle is Soar On, which is where purpose and connection live. In this category is also where I will put psychological stress. I have spoken to stress before here (http://www.renosoar.com/holistic-health-tips/5-reasons-stress-is-good-for-you) mostly as it is related to improving all aspects of your life. However, unchecked stress can build up and become problematic especially in the presence of painkillers. A mouse study evaluated the effect of psychological stress exacerbating nonsteroidal anti-inflammatory drug (NSAID) induced small bowel injury. The psychological stress, as a result of water avoidance, increased intestinal permeability in the presence of NSAID enteropathy as well as changing the microbiota. 32 It would appear that psychological stress unchecked might increase intestinal permeability.

Now that we can understand that the development of increased intestinal permeability or leaky gut has a variety of causes and risk factors, the question is, what can we do to resolve the problem or decrease intestinal permeability? It turns out that the solution is in the cause.

Eat Well – Solution

The first step in relation to healing leaky gut, is to remove the potential triggers like gluten, refined food products containing additives, and trans fats. Eating organic whole fruits and vegetables alongside healthy protein sources will be critical in the recovery of the intestinal integrity.

There are some other supplements that may facilitate permeability resistance, enhancing tight junctions, improving the microbiome and healing:

Move Well – Solution

Exercise has a multitude of benefits like strengthen muscle, improve mood, improve bone strength, improve wound healing, burn fat, and potentially slow aging. The World Health Organization recommends 150 minutes of moderate aerobic activity weekly and muscle strengthening twice a week. This could include playing with your kids, gardening or walking the dog. High intensity is considered short burst of all out exercise is as effective as longer workouts.

If you find yourself in the high-intensity exercise over long duration group putting you at risk, then the specific movement recommendation to restore gut integrity would be rest. The decrease in vagal activity helps to lower the risk of chronic disease and decrease the intestinal epithelial permeability.38

A rat study looked at the influence on the tight junctions in the ileum following endurance exercise. For the rat, the exercise was a treadmill for 60 min/day for 10 days at a work rate of 70% maximum oxygen consumption. This amount of exercise improved antioxidant enzymes and tight junction proteins as well as reduce inflammatory markers. 39 Although this doesn’t directly correlate with humans, one could safely assume that regular moderate-exercise (not extended high intensity in the heat) would likely produce similar results.

As I described above and describe in the book Soar Into Health, the importance of Vitamin D cannot be ignored. As stated previously, Vitamin D is a natural conversion of blood cholesterol in the presence of UVB spectrum sunlight hitting the skin. Specifically related to intestinal permeability, Vitamin D3 has been shown to preserve epithelial barrier function in the presence of intestinal injury, be it Crohn’s disease or ethanol-induced. 40-43 The free source of vitamin D3 is full sun exposure to a majority of your skin, without burning. Yet, during certain times of the year or even job requirements, it is not possible to get the needed skin exposure to produce adequate and therapeutic amounts. You can check your area at

www.aa.usno.navy.mil/data/docs.AltAz.php for when the sun is above the 50 deg altitude in order to provide UV B exposure for Vitamin D conversion.

If you are unable to get the needed exposure, then supplementation is a safe and maybe necessary option. A randomized double-blind placebo-controlled study in patients with Crohn’s disease found that 2000IU supplementation of D3 significantly increased blood levels and decreased intestinal permeability. 43

There is debate on what plasma level of Vitamin D3 is optimal and safe. A recent literature review report, evaluted the target values and upper limits of Vitmain D. The authors concluded the dose recommendation be based on body weight. They did conclude that serum 25(OH)D concentrations higher than 210 nmol/L as undesirable, but that 50 nmol/L is safe. 44

Below are two charts from www.vitamindcouncil.org that may help guide you personally as I would recommend testing your levels before supplementing and then retest after a period of time of supplementation. Remember that Vitamin D is a fat-soluble vitamin so a carrier fat is required when supplementing and D3 is the form most absorbable.

Vitamin D 25(OH)D range guidelines from various organizations:

Vitamin D Council

Endocrine Society

Food and Nutrition Board

Testing Laboratories

Deficient

0-30 ng/ml

0-20 ng/ml

0-11 ng/ml

0-31 ng/ml

Insufficient

31-39 ng/ml

21-29 ng/ml

12-20 ng/ml

Sufficient

40-80 ng/ml

30-100 ng/ml

>20 ng/ml

32-100 ng/ml

Toxic

>150 ng/ml

The Vitamin D Council suggests that a level of 50 ng/ml is the ideal level to aim for. This is why the Council recommends that adults take 5,000 IU/day of vitamin D supplement in order to reach and stay at this level.

Recommended daily intakes from various organizations:

Vitamin D Council

Endocrine Society

Food and Nutrition Board

Infants

1,000 IU/day

400-1,000 IU/day

400 IU/day

Children

1,000 IU/day per 25lbs of body weight

600-1,000 IU/day

600 IU/day

Adults

5,000 IU/day

1,500-2,000 IU/day

600 IU/day, 800 IU/day for seniors

The Food and Nutrition Board recommended daily intakes are the official recommendations by the United States government.

Can eating foods high in Vitamin D help raise my plasma levels?

Yes, eating foods high in Vitamin D like mushrooms and sardines is helpful. It is difficult, if not impossible, to reach the above recommendations on food alone especially in the absence of UV B sun rays.

Remove. Replace. Restore.

Remove avoidance of the sun and excessive intense exercise.

Replace with adequate skin exposure and supplement if needed to reach therapeutic Vitamin D3 levels. Exercise moderately, and sometimes intensely for short bursts with sufficient REST in between. Everyday life movement counts as exercise and has health benefits.

Restore intestinal integrity and resistance to infections.

Sleep well – Solution

As I described in Soar Into Health, sleep is critical for rest and recovery. Although sleep is characterized by a reduction in consciousness it is not the absence of activity. As I searched specifically for the benefits of sleep on the intestinal integrity, I came up empty handed for that specific condition. However, I did find a report that validated the idea that sleep has a direct effect on peripheral tissues, which includes, but not limited to, heart, lung, and likely gastrointestinal tissue as well. Sleep actually enhances organ specific molecular functions by reducing metabolic stress. Sleep may even synchronize all of our organs.45

The amount of sleep required for each individual varies based on age and lifestyle. As a general rule, waking on your own feeling rested in the morning is an indication of adequate sleep. The amount for adults 26-64 years is 7-9 hours. 46 Given the habit of sleep deprivation in our culture, I recommend determining the hour you need to wake and count back 9 hours for determining bedtime. More details can be found in Soar Into Health. A few tips to optimize sleep are:

Keep your bedroom cool (60-72 F).

Keep your room dark, dark, dark.

Turn off all screens 1-2 hours before determined bedtime.

Keep all screens out of the bedroom.

Get natural sunshine in the morning and during the day.

Make bedtime a routine.

Eat Well.

Move well.

Remove. Replace. Restore.

Remove sleep disruptors and regular late nights

Replace with a regular bedtime in a dark room to allow for a minimum of 8-9 hours of sleep so you wake rested.

Soar On –Solutions

As I described earlier that physiological stress may increase intestinal permeability. You may ask yourself, how is it possible to address the stressful life components when they are out of your control? For example, being a parent requires managing many young children who are dependent on you and short of leaving, there is no way to change that responsibility or stress. The same goes for many professionals. Stress is a part of life. Although your perception of stress plays a role in how your body handles stress, how can you improve your intestinal permeability by reducing stress that is often a fixed part of life?

Much like sleep, I was unable to find a direct resource demonstrating a decreased in intestinal permeability with stress reduction techniques. What I did find is a study using mindfulness-based program for resilience training in healthcare professionals. The pilot-program included eight weeks on mindfulness program combining meditation with nutrition and exercise resulting in a reduction in stress, depression and anxiety47 (all symptoms that could be correlated with leaky gut syndrome.)

Another study evaluated women healing from breast cancer, a clearly stressful diagnosis, found that 20-sessions of contemplative self-healing improved quality of life and decreased symptoms of post-traumatic stress.48

Although these particular studies were not directly related to intestinal permeability, they do indicate the powerfulness of meditative or self-healing as a means for relieving symptoms of stress.

As a clinician, I often recommended a simple 10 min practice of diaphragmatic breathing as a potential for calming the nervous system and triggering the body to reduce vagus nerve stimulation, which is often associated with increased pain states. Performing simple activities to calm the nervous system have only benefits to release stress without removing your life stress…like kids.

A study from an alternative journal reported a decrease in blood viscosity (a potential risk factor for cardiovascular disease) with earthing (grounding) by simply exposing the human body to the surface of the earth. Although this experiment used an artificial grounding model of electrical stimulation, 49 I like the idea of simply putting your bare feet on the earth, or even hugging a tree. Better yet, go walk in the sunshine through the trees to get grounded and release the pent up stress.

Stress is what makes our lives more beautiful. Yet, ignoring the impact of stress in your life and attempting to ignore it, exercise it away, or eating junk food may be counter productive when it comes to leaky gut. The best way to release stress is a personal proposition. Some things that may help release stress are:

Prayer

Meditation

Talking with a good friend or family member

Diaphragmatic Breathing

Walking in nature

Touching the earth

Hugging a pet or loved one

Crying

Singing

In the end, it’s personal. Finding your release only takes trial and error.

Remove. Replace. Restore.

Remove anxiety about stress in your life

Replace with a means to release the stress in your life. Try different ideas to find one that fits your personality and lifestyle, but commit to it regularly if not daily.

Restore a healthy gut…even with stress in your life.

Eat Well. Move Well. Sleep Well. Soar On….to heal a leaky gut.

References:

de Punder K, Pruimboom L. The dietary intake of wheat and other cereal grains and their role in inflammation. Nutrients. 2013;5(3):771-787.

On this episode of the podcast we have guest Dr. Bryan Walsh. Dr. Walsh is a licensed, board-certified Naturopathic Doctor, an expert in biochemistry and human physiology, and currently delivers courses in biochemistry, physiology, and pathophysiology as an Instructor at Maryland University of Integrated Health. Listen in as we talk all about the myths and truths of “adrenal fatigue”, the causes of low cortisol, interaction with the immune system, testing, and more. This was a super interesting episode, and I even learned a good bit on the topic myself. Definitely give this one a listen!

30 Day Guide to the Paleo Diet

Want some extra help? Have you been trying Paleo for a while but have questions or aren’t sure what the right exercise program is for you? Or maybe you just want a 30-day meal plan and shopping list to make things easier? We’ve created a getting started guide to help you through your first 30 days.

]]>http://robbwolf.com/2016/11/08/episode-342-dr-bryan-walsh-adrenal-fatigue-and-low-cortisol/feed/7How Much Protein Do We Really Need?http://robbwolf.com/2016/11/07/how-much-protein-do-we-really-need/
http://robbwolf.com/2016/11/07/how-much-protein-do-we-really-need/#commentsMon, 07 Nov 2016 20:21:05 +0000http://robbwolf.com/?p=19564Continue Reading]]>Every time I watch a documentary on global warming, the idea of cutting down on energy consumption seems to get completely glossed over and the take away is: EAT LESS MEAT. I also hear this from the health community. When I was in school to become a dietitian, the constant message was that people are EATING WAY TOO MUCH meat; we’re getting more than enough protein.

I think the growth of the vegan and vegetarian movement is based primarily on emotions, with cherry-picked data to back it up with “logic.” Meat has long been considered “evil.” In fact, corn flakes were invented by John Harvey Kellogg to stop masturbation. He felt that eating spicy, protein-rich foods lead to increased sexual arousal. The guy was on a mission to end sex all together, which he felt was at the root of many health issues like epilepsy and cancer. In addition to advocating a meatless diet, did all kinds of sick things, especially to kids and women.

Today, eating a plant-based diet is still associated with being “clean” and “pure.” When looking at the “levels of vegetarianism,” eating red meat is considered the “worst,” with no real logic to back this up in my mind. How is eating chicken a “cleaner” choice than beef? If you’ve ever raised chickens, I’m sure you’ll agree that they are NOT clean, pure, or any better of a choice than a cow, sheep, or lamb. Chickens are actually quite dirty and are cannibals; they will peck each other to death if stressed – and CAFOs are pretty stressful on chickens.

Environmentalists say that beef is destroying the environment, and health advisors are saying that it’s killing us. As a “real food” dietitian who lives on a working farm, I understand the importance of properly raised herbivores in helping to sequester carbon. I tend to talk about the benefits of meat in nutrition to environmentalists, and talk about the importance of regenerative agriculture to the nutrition crowd. There doesn’t seem to be a lot of overlap in these two areas. It’s like you can’t possibly be “pro planet” and “pro meat” at the same time. Am I really the only one who thinks this is possible?

There seems to be a big disconnect. I personally don’t think that you have to give up meat if you want to be an environmentalist. I wonder if our assumption that we’re eating “so much protein/meat” is actually a result of feeling guilty about eating meat in general.

“When you assume, you make an ass out of you and me.” – Mr. Mangano, my high school math teacher.

When I attend the environmental conferences, I don’t see any dietitians on the “How Much Meat Should We Eat?” panels. It’s usually a bunch of chefs saying, “Less Meat, Better Meat.” This is a very popular position to take, but is it correct? I don’t see data/studies being referenced on how much meat we’re ACTUALLY eating, or how much protein humans really need.

So, I decided to do some research. How much protein do we actually need? What is this based on? How much protein/meat are we actually eating? Is it really too much, enough, or too low? What are the best sources of protein for vegetarians? Why do women in particular avoid red meat? Originally, I thought this would a simple, maybe 500 word post. I actually opened a big can of worms, so I need to break it into several separate posts. Here’s the answer to the first question, plus a look into what happens when we over or under eat protein.

The current RDA for protein intake is explained in the Dietary Reference Intakes by the Institute of Medicine, which based protein intake recommendations on nitrogen balance studies. Nitrogen balance is the difference between nitrogen intake and excreted nitrogen. It’s difficult to measure, and varies greatly between individuals. It’s very easy to underestimate adequate protein levels based on these studies. In fact, here is a direct quote from the paper, “In adults, it is generally presumed that the protein requirement is achieved when an individual is in zero nitrogen balance. To some extent, this assumption poses problems that may lead to under-estimates of the true protein requirement.”

Way before these guidelines were introduced, much higher protein recommendations were proposed. In this 1912 book, nitrogen balance studies were questioned as inaccurate measures of protein requirements, and a recommendation of at least 100 grams of digestible protein (so, not just grams of protein, but the bioavailability of the protein) be consumed.

Translating the RDA of 0.8g protein/kg BW to the public is difficult (some people I’ve talked to don’t even know what protein is), so the folks who put together the US Dietary Guidelines decided to give actual numbers to people. They based the numbers on a “reference” man of 70kg (154lbs) and a “reference” woman at 57kg (125lbs). So, if you look up, “How much protein should I eat?” the numbers you’ll often find are 56 grams a day for men and 46 grams per day for women. These are based on 0.8g protein per kg BW based on those references. The problem is, how many men do you know who are 154lbs and women who are 125lbs? NOT MANY.

I then checked out what the CDC says for the average American man: 88.6kg (195.5lbs) and the average woman is 75.6kg (166.2lbs). That’s a big difference from the above “ideal” man and woman! According to the 0.8 grams of protein calculation, that the average American man needs 71 grams of protein per day and the average American woman needs 60 grams, at a minimum. This still represents a relatively low protein intake in my opinion, so I kept looking around for more information.

The USDA Estimated Caloric Needs Per Day recommends about 2000 calories per day diet for average, moderately active women and about 2600 calories per day for moderately active men. The “reference” woman is 5 feet 4 inches tall and weighs 126 pounds and the “reference” man is 5 feet 10 inches tall and weighs 154 pounds. Again, these are not “average” weights for Americans. Using 10%-35% of calories from protein, the reference woman would need 50 – 175 grams of protein per day, and the reference man needs 65 – 228 grams of protein per day. This is a very large range! This makes the RDA of 0.8g/kg at below the ADMR range. So, given this context, are we still eating too much protein?

Interestingly, I found a post published by the US Library of Medicine, recommending a person on a 2,000 calorie diet get 20% of their calories from protein. This means a target of 100 grams per day. This number is about DOUBLE what the US Dietary Guidelines recommend.

I was also wondering if the US Military had slightly different recommendations. There is a Military Recommended Daily Allowance (MRDA) for rations. MRDA for protein are based, in part, on an estimated nutritional requirement of 0.8 gm/day/kg of body weight. (See table 2–1.)

“Protein allowance is based on an estimated protein requirement of 0.8 gm/kilograms (kg) desirable body weight. Using the reference body weight ranges for males of 60 to 79 kilograms (132 – 173lbs) and for females of 46 to 63 kilograms (101 – 138lbs), the protein requirement is approximately 48 to 64 grams for males and 37 to 51 grams for females. These amounts have been approximately doubled to reflect the usual protein consumption levels of Americans and to enhance diet acceptability.”

When you see the table, the protein recommendation is 100grams. Why would the army just go ahead and DOUBLE the protein recommendations, if they were based on any kind of science?

And if things were’t confusing enough, I looked at “My Plate” recommendations, which are intended to be how the US Dietary Guidelines are broken down into “simple” terms, to used as a mass teaching tool. Here is what they recommend for intake from “protein” foods:

You’ll see that the protein recommendations are listed as ounce “equivalents”. My Plate says, “In general, 1 ounce of meat, poultry or fish, ¼ cup cooked beans, 1 egg, 1 tablespoon of peanut butter, or ½ ounce of nuts or seeds can be considered as 1 ounce-equivalent from the Protein Foods Group.”

The problem is that the ounce equivalents really aren’t equal if you look up the grams of protein they have. One ounce chicken or roasted beef equals about 8-9 grams of protein, 1 oz of fish is about 6, and 1 egg has 6 grams. For the non-meat options, 1 tablespoon of peanut butter has 4g protein and 1/4 cup of cooked beans has 4.2 grams of protein. So, if a woman following the above guidelines ate the recommended 5 ounce equivalents of protein they would get about 6 grams per ounce, for about 45 grams per day.

Now, My Plate also recommends 3 cups of milk for men and women. It also offers other options to drinking milk, “In general, 1 cup of milk, yogurt, or soymilk (soy beverage), 1 ½ ounces of natural cheese, or 2 ounces of processed cheese can be considered as 1 cup from the Dairy Group.”

1 cup of 1% milk has 8g of protein. 1 cup of low fat yogurt has about 11g of protein, 8 grams in a cup of soy milk, and 1.5 oz of natural cheese has 10g of protein, so when you add the dairy in, the average woman is getting about 27 more grams of protein from the milk group, on top of the protein foods group. However, many people in the world are lactose intolerant, and milk is not part of the dietary guidelines of most countries. Three cups of milk/servings of dairy is a lot in my opinion.

There is also some protein (not much) in grains and vegetables, so this could add on a few more grams. So, when you look at it, the My Plate recommendations actually equal about 75g of protein when you add dairy and other foods to the “protein foods” group for the “average” woman and 81g of protein for “average” men. This is at the lower end of the ADMR of 10% – 35%. For a woman, 75g of protein on a 2,000 calorie diet is only 15% of calories from protein, and it’s an even lower percentage, at 12 % for a man on a 2600 calorie diet. These are the caloric recommendations in the US Dietary Guidelines for men and women with “moderate” activity levels, ages 26 – 45. Also, the guidelines say that we should limit our sugar intake to less than 10% of calories. How is protein basically at the same nutritional status as sugar? No wonder why nobody trusts nutrition advice anymore.

2. Are there dangers of eating too much protein?

According to the Dietary Reference Intakes by the Institute of Medicine, “the current state of the literature does not permit any recommendation of the upper level for protein to be made on the basis of chronic disease risk.” and, “high protein intake had no detrimental effect on protein homeostasis.” This study also showed no harmful effects of a diet of >3g/kg/d in healthy, resistance-trained men.

In my clinical practice, when I recommend about 100 grams of protein a day, largely from animal sources, I sometimes get push back. Some women tend to think it’s “gross” to eat that much, and they think it’s too “heavy” or they feel bad to be eating so many animals. I address the moral argument here, and am exploring women’s relationship to red meat more in this recent post. I find that most men don’t argue quite as much. When I tell them to eat meat, they are pretty psyched.

Others have heard that meat can cause cancer and is harmful to the kidneys. The fact is, in healthy people, increased protein intake has no harmful effect on the kidneys at all. The kidneys simply adapt. While low protein diets can be therapeutic for those with kidney disease, this does not mean that a high protein diet caused kidney disease. Chris Kresser expands on meat and it’s relation to kidney function, cancer, and IGF-1 (it’s probably the methionine, not the protein) in this post.

There are several hunter gatherer cultures that eat lots of meat, however just because they’re eating meat, doesn’t meat their diet is only protein. One study of an Eskimo population in 1855 found that when they were eating an “all meat” diet, their protein intake was only 44% due to high fat intake. During times of plenty, they would consume 4 to 8 pounds of meat a day, with a daily average food partition of about 280 gm. of protein, 135 gm. of fat, and 54 gm. of carbohydrate of which the bulk is derived from the glycogen of the meat eaten. Early American explorers survived for extended periods of time only on pemmican, a food made of dried lean meat mixed with fat, with a protein content of 20 to 35%.

Protein is the most satiating of the macronutrients, and intakes of 15% – 30% of caloric intake can be quite helpful in regulating appetite by increasing leptin sensitivity and induces weight loss and increase blood sugar control. In this meta-analysis, high protein diets of 25% – 32% of calories compared to the control groups of 15% – 20% (which is still higher than the RDA), showed beneficial effects on weight loss, HbA1C levels and blood pressure in patients with type 2 diabetes. This post shows that increased protein seems to be the key to a hunger-free diet, as weight loss in two studies was successful in both low-carb and low-fat diets when protein was between 22% – 25%.

3. What are the dangers of eating too little protein?

Your body needs protein, and if you don’t get it through diet, your body will start breaking down your muscle and other tissues in order to get protein. This leads to muscle wasting and weakness. Immune function decreases because protein is required for antibodies. Adequate protein is also required for bone health. You also need protein as enzymes and to carry oxygen to tissues, so low protein can cause lethargy. Low protein is also associated with hair loss, brittle nails and cold hands and feet. Low protein can cause weight gain. B12 deficiency (a vitamin only available in animal protein) has been shown as an independent risk factor for coronary artery disease and serious neurological disorders in infants of vegan mothers.

4. So, how much protein should you eat?

In summary, we are being told to eat 0.8g/kg of protein per kg of bodyweight. We’re also being told by My Plate that nearly 60% of our dietary intake of protein should be in the form of dairy or soy milk products. It’s incredibly confusing to determine how much meat to eat and the recommendations don’t really seem to be based on much science, due to the inaccuracy of nitrogen balance studies and the gigantic ranges from the ADMR.

It seems that 100g of protein on a 2,000 calorie diet is a very reasonable amount, and many of you are eating much more than 2,000 a day, so this means beef up your protein, folks. Most Americans report eating between 1800 and 2500 calories per day (and self-reported data is usually on the low end) so this means, at 20% of calories, intake for Americans should really be between 90 and 125 grams of protein per day. If you’re getting this from meat, that looks like around 12oz – 16oz of meat a day. Break that between three meals, and this is 4-6oz of animal protein per meal. More if you’re eating more calories, or have a need for increased protein. So, the next time someone says to you we need to eat “less meat, better meat,” please share this post with them, and ask them how much protein they’re actually eating.

I had the good fortune of meeting Robb Wolf for the first time at the Ketogains Conference, which took place recently in Las Vegas, Nevada on October 8-9, 2016. As we snacked on Quest Nutrition low-carb snickerdoodle cookies and sipped on Pruvit exogenous ketone supplements, we started waxing philosophical about the different approaches to healthcare. In particular, we were discussing the differences between the approaches of conventional medicine and those used by ancestral health.

Dave and Robb at the Ketogains event

Our discussion brought us to the analogy of two computer operating systems fighting it out in the market for the mindshare of consumers. In one corner we have the incumbent, Microsoft Windows, an OS that has dominated the desktop market for the last couple of decades.

In the other corner we have the challenger, Apple’s Mac OS, an elegant alternative that has been winning the hearts and minds of users all over the world. But under the covers, Mac OS is just a modern user interface on top of the UNIX operating system, which has been around since the dawn of computers – long before Microsoft even existed.

Mac OS: A sexy user interface on top of the ancient UNIX operating system

In healthcare we can make a similar comparison. We have a three trillion dollar conventional health system that’s been the status quo for many decades. It uses the latest science and technology to tackle some of healthcare’s biggest challenges.

Conventional systems developing the latest medical technology

We also have alternative approaches based on ancestral health. These approaches are resurrecting millennia old principles (e.g. mindfulness meditation) and leveraging features of our own evolution to evoke natural strategies for healing (e.g paleo and ketogenic diets). “Ancestral health” is simply a new way to describe ancient biotechnology that’s been around since the dawn of mankind – long before the techniques conventional medicine ever existed.

Ancestral health: A new spin on ancient health principles

Patients in the Middle

Many of us find ourselves somewhere in the middle. We prefer the ancestral approaches as a first line of defense to manage our health through natural and non-pharmaceutical means.

And yet we still leverage the conventional systems for acute care, medical emergencies, advanced diagnostic testing and perhaps the occasional prescription. Additionally, many of us rely on the conventional systems to run our lab tests and bill our health insurance providers.

We may also use a hybrid approach where we are working with practitioners from both conventional and ancestral disciplines to tackle our most challenging ailments. Many of my close friends and family have been in this exact situation and have seen very positive outcomes by combining the best of both disciplines.

Managing our Medical Records

The challenge for many of us becomes trying to effectively manage our health data as we navigate between these two models of care.

We may have valuable health history stored in the conventional systems. Unfortunately, these systems are highly fragmented. There is no easy way to extract our medical records and centrally manage this data on our own.

For example, in my own case, I have to login to three different patient portals (Stanford, UCSF and St. Mary’s) in the state of California just to try and cobble together my historical data from the conventional systems.

Challenges with the conventional system – fragmented medical records

And yet, as we move down the ancestral path, we need our data from the conventional systems more than ever. We need to somehow share this valuable clinical history with our ancestral health provider. For example, my Functional Medicine doctor is in Austin, Texas and I am in San Francisco, CA. We meet over Skype and use screen-sharing technology for our consultations.

The ancestral provider will likely be ordering their own specialized tests for their patients. Functional medicine tests like GI stool tests, adrenal stress tests, intestinal permeability tests and heavy metals testing. We need a way to centrally track and manage this information too.

As patients who want to be empowered to make the best decisions possible, how do we manage all of this information?

Heads Up Health – Technology Solution

Frustrated by the challenges of data management on my own health journey, I set out to build a better solution. My company, Heads Up Health, is building an electronic health records solution to address these challenges.

We are taking a very different approach from traditional electronic health records. We believe that all health data should be engineered around the patient. With that goal in mind, we’ve designed our software application around the following principles:

1. Show me all of my medical records in one place

Heads Up Health can electronically connect to over 3,000 conventional health systems across the country. If you’ve been to more than one facility, you can connect them all to Heads Up Health and the software will organize all the data for you automatically.

Electronically centralizing your medical records with Heads Up Health

For records that are still on paper or PDF, you can enter that data manually or use our ‘Concierge Service’ to handle the data entry for you.

2. Integrate the data I am collecting at home

Being able to see how your day-to-day lifestyle choices (which we can now measure with digital health devices and apps) are correlated with your clinical data can be incredibly powerful.

Whether it’s a $20 bathroom scale, your ketone or blood sugar readings or the latest Apple Watch, we make it easy to integrate the data you are collecting at home with the data contained in your medical records.

Connecting your digital health data into your Heads Up profile

3. Tell me how to improve my health

Now that I’ve got all this data in one place, how do I use it for better decision-making?

Intuitive dashboards, trends, alerts, insights and other powerful analytical tools will empower you to get the most out of your data and use this information to help guide you own your path to optimal health.

Heads Up Health dashboards

4. Share your health history with any provider you choose

Healthcare comes from more than just your conventional and/or ancestral doctors. It comes from your family members, your dentist, your optometrist, your personal trainer and your chiropractor, among others.

With Heads Up Health, you’re the hub of your data, so you can choose what you share and who you share it with in an easy and secure manner.

Securely share your Heads Up profile with your entire care team

You. Empowered.

With a powerful health portfolio in hand, we aim to empower you take control of your health. You can leverage data to learn exactly what works for you own specific body and your own specific health outcomes. You have the freedom to consult with any health expert, any time, anywhere in the world and have your entire health history at your fingertips. You can leverage services from conventional or ancestral systems as needed, knowing you have an easy way to synchronize all of your health data. You can experience for yourself how the right data can be a powerful tool for health transformation.

Lastly, Heads Up Health software runs in the cloud. So regardless of whether you are Mac or a PC person, you can access your health data any time, from any device, anywhere in the world.

I have been seeing a few interesting posts on the internet in the last week or so. These posts were discussing corrective exercise and the importance of getting stronger as well as the importance of the person’s psyche in getting better.

These articles really struck a chord with me, as they are directly in line with my beliefs. First, I want to discuss a person’s psyche when taking part in a strength and conditioning program after some type of injury. The post that I had read was from Dr. John Rusin, a physical therapist. It stated that as clinicians, no one should tell a client they will never be able to do certain exercises ever again.

For example, you should never squat and deadlift again due to your back injury. Telling a client this is going to immediately make them fear this exercise. It can also lead them to altering movement patterns. Fear of injury changes the way we move, and whether that doctor likes it or not, that person is required to squat and deadlift all of the time to go through life.

Anytime that person gets up or goes down to a chair, or needs to pick up something to move, he or she is squatting and deadlifting. You can’t avoid these movements in life, so why would you avoid them in the gym? Now you put fear in a client and every time they sit down or stand up, or have to pick up something from the floor, they are going to move with a fear of injury. This can actually lead them to getting injured.

Wouldn’t we want to strengthen these movements? There will be times when a person cannot squat or deadlift, but in these cases our job is to put them in a position to work towards doing those things. In most cases as a strength coach, if a person comes in with an injury or has been cleared from a PT, they will be able to bodyweight squat and kettlebell deadlift at the minimum. Maybe the bodyweight squat is performed to a high box and the kettlebell deadlift is raised up from the floor to start.

You may be saying “Well I would assess that client to see what he or she can and cannot do.” This is not a terrible answer, but may not be the best answer either. Let us look at an example. The Functional Movement Screen (FMS) by Gray Cook is a widely used assessment. This is a great tool to have in the tool box, but not the end all be all of training clients.

One of the tests is called the active straight leg raise (ASLR). Basically, you have the client lie on their back and lift one leg as far as they can without bending either knee. Depending on their available range of motion it is scored a 1, 2, or 3. Anything less than a 2 is failing and an asymmetry between left and right side cannot be ignored. A 0 is when pain is present and a referral is suggested.

Many people will tell you that a score of a 1 or asymmetries between left and right rules out deadlifting from the floor until it is corrected. You know what fixes these scores? A well coached and executed deadlift.

A well executed deadlift requires us to breathe properly, brace our abs, hinge at the hips and extend through the t-spine to strengthen our posterior chain. Not only is it teaching us how to move properly, but it is strengthening the muscles that actually protect our spine. The stronger these muscles are, the safer our back is.

Just laying on our backs and working on breathing drills, hip lifts, and light stretching is not enough (although these exercises do have their place). The overload principle applies to corrective exercise as well. You need to do enough to actually strengthen the tissues that surround the joint. We need enough intensity to strengthen our motor control as well. The stronger we get in each movement, the easier it is to walk around, get up and down, pick things up, and so on.

The breathing drills, hip bridges, and light stretching can be exercises to prep us for the bigger movements. These exercises make the perfect warm-up if they are weaknesses that have been discovered in an assessment. Keep in mind the overload principle when coming up with a warm-up as well. The exercises need to advance and become more challenging as the earlier ones become too easy.

In the FMS and other assessments they suggest that you refer out if there is pain found in any of the tests. This is more for liability reasons, and it is not necessarily wrong. However, is it in the best interests of the clients? Sometimes a referral is absolutely necessary, but other times it is not.

For example, if someone’s hip hurts during an overhead squat test, you are told to score it a 0 and refer out. The problem with this is that their hip might just be pinching because their squat looks like garbage. Is a poorly executed squat that leads to hip pain a referral to a doctor? I do not think so. Take them and teach them to execute the squat well and see how they respond. In most cases the pain will go away. This is a case where good coaching is corrective exercise. If you cannot get them to move around pain free within a couple of minutes then I would suggest referring them out.

Never tell a client that they cannot do an exercise because they failed an assessment or have a previous injury. This can create fear within the client and actually alter how they perform daily tasks. It is our job as coaches to teach them to move properly and to strengthen those movements. There is nothing better to do this than big barbell lifts such as squats and deadlifts. There will be cases where some people will not be able to execute a proper squat and/or deadlift. In these cases start them where there is not pain and progress appropriately.